Evaluation of the Quality of the Case Reports in Journal of Korean Medicine from Year 2015 to 2020 : Using CARE Guidelines

Ji Hye Hwang; Jaseung Ku; Eun-Young Nam; Hwang, Ji Hye; Ku, Jaseung; Nam, Eun-Young

doi:10.13048/jkm.20016

JKM > Volume 41(2); 2020 > Article

Hwang, Ku, and Nam: Evaluation of the Quality of the Case Reports in Journal of Korean Medicine from Year 2015 to 2020 : Using CARE Guidelines

Original Article

The Journal of Korean Medicine 2020; 41(2): 80-95.

Published online: June 1, 2020

DOI: https://doi.org/10.13048/jkm.20016

Evaluation of the Quality of the Case Reports in Journal of Korean Medicine from Year 2015 to 2020 : Using CARE Guidelines

Ji Hye Hwang¹

, Jaseung Ku²

, Eun-Young Nam³^{, *}

¹Dept of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Gachon University

²Bogwang korean medical clinic

³Dept of Obstetrics and Gynecology, College of Korean Medicine, Gachon University

Correspondence to: Eun-Young Nam, Department of Obstetrics and Gynecology, College of Korean Medicine, Gachon University, 21 Keunumul-ro, Jung-gu, Incheon, Korea., Tel: +82-32-770-1292, E-mail: obgyney@gachon.ac.kr

Received May 14, 2020 Revised May 25, 2020 Accepted May 25, 2020

Abstract

Objectives

The purpose of this study is to assess the quality of the Journal of Korean medicine case reports.

Methods

Case reports published in the Journal of Korean Medicine from January 2015 to March 2020 were selected by using Oriental Medicine Advanced Searching Integrated System (OASIS) and the journal search system of the Korean Medical Association (https://www.jkom.org). The quality of the case reports was assessed using the Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines.

Results

33 case reports were selected for the assessment. Based on the CARE guidelines, 61.54% of the case reports included necessary information, but the quality level was uneven. More than 60% of the reports were missing data regarding ‘Discussion of the strengths and limitations in your approach to this case’, ‘Intervention adherence and tolerability’, ‘Timeline’, ‘Medical, family, and psychosocial history including relevant genetic information’, ‘Patient perspective or experience’, ‘Adverse and unanticipated events’, ‘Administration of intervention’, and ‘De-identified demographic information and other patient specific information’. In most reports of over 90%, data regarding ‘Diagnostic challenges’, ‘Intervention adherence and tolerability’, and ‘Key word’ were not included.

Conclusions

Efforts are needed to improve the quality of case reports in the Journal of Korean Medicine, and it is necessary to develop appropriate guidelines for case reporting for the Journal of Korean Medicine. In addition, all articles submitted to the Journal of Korean Medicine are to be complied with submission instructions and CARE guidelines.

Keywords: Case Reports, Journal of Korean Medicine, Reporting Guidelines, Quality, CARE(CAse REports) Guidelines

Figure. 1

Flow chart of case reports identified, screening, included process

Figure. 2

Case Reports According to The Quality of Reporting Evaluated by Each Item of CARE Guidelines

Table 1

Percentage of Items Reporting according to CARE Guide by Each Case Report

Case reports	Reporting						Not-Reporting

	Sufficient		Not-Sufficient

First author (year)	n1/N	%	n2/N	%	(n1+n2)/N	%	n3/N	%
Lee KH (2015)16)	12/26	46.15	9/26	34.62	21/26	80.77	5/26	19.23
Son K (2015) 17)	17/26	65.38	5/26	19.23	22/26	84.62	4/26	15.38
Yang J (2015)18)	16/27	59.26	6/27	22.22	22/27	81.48	5/27	18.52
Jo EH (2015)19)	12/26	46.15	10/26	38.46	22/26	84.62	4/26	15.38
Min DL (2015)20)	16/26	61.54	9/26	34.62	25/26	96.15	1/26	3.85
Lee HY (2015)21)	17/26	65.38	8/26	30.77	25/26	96.15	1/26	3.85
Kim JY (2015)22)	15/27	55.56	8/27	29.63	23/27	85.19	4/27	14.81
Sung SH ((2015)23)	15/26	57.69	7/26	26.92	22/26	84.62	4/26	15.38
Nam SH (2015)24)	16/26	61.54	5/26	19.23	21/26	80.77	5/26	19.23
Baik TH (2016)25)	16/26	61.54	5/26	19.23	21/26	80.77	5/26	19.23
Yang J (2016)26)	13/26	50.00	8/26	30.77	21/26	80.77	5/26	19.23
Seo YH (2016)27)	17/26	65.38	6/26	23.08	23/26	88.46	3/26	11.54
Jeon H (2016)28)	16/28	57.14	6/28	21.43	22/28	78.57	6/28	21.43
Yang JE (2016)29)	12/26	46.15	9/26	34.62	21/26	80.77	5/26	19.23
Son CG (2016)30)	14/26	53.85	7/26	26.92	21/26	80.77	5/26	19.23
Jo NY (2016)31)	16/26	61.54	8/26	30.77	24/26	92.31	2/26	7.69
Yang J (2016)32)	16/26	61.54	5/26	19.23	21/26	80.77	5/26	19.23
Cha J (2016)33)	18/26	69.23	3/26	11.54	21/26	80.77	5/26	19.23
Son CG (2017)34)	16/26	61.54	5/26	19.23	21/26	80.77	5/26	19.23
Song SY (2017)35)	19/28	67.86	4/28	14.29	23/28	82.14	5/28	17.86
Choi JW (2017)36)	18/27	66.67	6/27	22.22	24/27	88.89	3/27	11.11
Yang J (2018)37)	20/27	74.07	3/27	11.11	23/27	85.19	4/27	14.81
Ryu JY (2018)38)	17/26	65.38	5/26	19.23	22/26	84.62	4/26	15.38
Lee ES (2018)39)	20/27	74.07	2/27	7.41	22/27	81.48	5/27	18.52
Kim M (2018)40)	16/26	61.54	5/26	19.23	21/26	80.77	5/26	19.23
Jung MY (2018)41)	18/26	69.23	3/26	11.54	21/26	80.77	5/26	19.23
Lee S (2018)42)	16/27	59.26	6/27	22.22	22/27	81.48	5/27	18.52
Lee S (2018)43)	15/27	55.56	7/27	25.93	22/27	81.48	5/27	18.52
Cho AR (2018)44)	10/26	38.46	10/26	38.46	20/26	76.92	6/26	23.08
Geum JH (2019)45)	18/26	69.23	5/26	19.23	23/26	88.46	3/26	11.54
Shin J (2019)46)	15/26	57.69	7/26	26.92	22/26	84.62	4/26	15.38
Kim S (2019)47)	20/27	74.07	4/27	14.81	24/27	88.89	3/27	11.11
Lee SH (2020)48)	14/26	53.85	7/26	26.92	21/26	80.77	5/26	19.23
Max. of %		74.07		38.46		96.15		23.08
Min. of &		38.46		7.41		76.92		3.85
Median of %		61.54		22.22		81.48		18.52

1) ‘n1’, ‘n2’, and ‘n3’ mean the number of which items match each assessment-criteria: Sufficient, Not-sufficient, and Not-reporting, respectively.

2) ‘N’ means the number of applicable item.

Table 2

Percentage of Items Reporting according to CARE Guide by Each Year

Year	Reporting									Not-Reporting

	Sufficient			Not-Sufficient			Total

	Max. of %	Min. of %	Median of %	Max. of %	Min. of %	Median of %	Max. of %	Min. of %	Median of %	Max. of %	Min. of %	Median of %
2015 (n=9)	65.38	46.15	59.26	38.46	19.23	29.63	96.15	80.77	84.62	19.23	3.85	15.38
2016(n=9)	69.23	46.15	61.54	34.62	11.54	23.08	92.31	78.57	80.77	21.43	7.69	19.23
2017(n=3)	67.86	61.54	66.67	22.22	14.29	19.23	88.89	80.77	82.14	19.23	11.11	17.86
2018(n=8)	74.07	38.46	63.46	38.46	7.41	19.23	85.19	76.92	81.48	23.08	14.81	18.52
2019–2020(n=4)	74.07	53.85	63.46	26.92	14.81	23.08	88.89	80.77	86.54	19.23	11.11	13.46

Table 3

Percentage of Case Reports with Reporting Items of CARE Guide by Each Item

Topic		Items	Sufficient		Not-Sufficient *		Not-Reporting
Topic		Items	n/N	%	n/N	%	n/N	%
Title	1	The words “case report” should be in the title along with the area of focus	25/33	75.76	8/33	24.24	-	-
Key word	2	2 to 5 key words that identify areas covered in this case report	2/33	6.06	31/33	93.94*	-	-
Abstract	3a	Introduction-What is unique about this case? What does it add to the medical literature?	30/33	90.91	2/33	6.06	1/33	3.03
	3b	The main symptoms of the patient, the important clinical findings, the main diagnoses, therapeutics interventions, and outcomes	24/33	72.73	9/33	27.27	-	-
	3c	Conclusion—What are the main “take-away” lessons from this case?	32/33	96.97	1/33	3.03	-	-
Introduction	4	One or two paragraphs summarizing why this case is unique with references	33/33	100.00	-	-	-	-
Patient information	5a	De-identified demographic information and other patient specific information	13/33	39.39	20/33	60.61*	-	-
	5b	Main concerns and symptoms of the patient	32/33	96.97	1/33	3.03	-	-
	5c	Medical, family, and psychosocial history including relevant genetic information (also see timeline). Relevant past interventions and their outcomes	7/33	21.21	26/33	78.79*	-	-
Clinical findings	6	Physical examination findings	30/33	90.91	3/33	9.09	-	-
Timeline	7	Important information from the patient’s history organized as a timeline	7/33	21.21	25/33	75.76*	1/33	3.03
Diagnostic assessment	8a	Diagnostic methods (such as PE, laboratory testing, imaging, surveys)	32/33	96.97	1/33	3.03	-	-

	8b	Diagnostic challenges (such as access, financial, or cultural)	-	-	-	-	33/33	100.00*
	8c	Diagnostic reasoning including other diagnoses considered	17/33	51.52	13/33	39.39	3/33	9.09
	8d	Prognostic characteristics (such as staging in oncology) where applicable	5/33	15.15	-	-	28/33	84.85*
Therapeutic interventions	9a	Types of intervention (such as pharmacologic, surgical, preventive, self-care)	33/33	100.00	-	-	-	-
	9b	Administration of intervention (such as dosage, strength, duration)	13/33	39.39	20/33	60.61*	-	-
	9c	Changes in intervention (with rationale)	6/33	18.18	1/33	3.03	26/33	78.79*
Follow-up and outcomes	10a	Clinician and patient-assessed outcomes (when appropriate)	32/33	96.97	1/33	3.03	-	-
	10b	Important follow-up diagnostic and other test results	32/33	96.97	-	-	1/33	3.03
	10c	Intervention adherence and tolerability (How was this assessed?)	1/33	3.03	1/33	3.03	31/33	93.94*
	10d	Adverse and unanticipated events	13/33	39.39	1/33	3.03	19/33	57.58*
Discussion	11a	Discussion of the strengths and limitations in your approach to this case	16/33	48.48	17/33	51.52*	-	-
	11b	Discussion of the relevant medical literature	28/33	84.85	5/33	15.15	-	-
	11c	The rationale for conclusions (including assessment of possible causes)	21/33	63.64	12/33	36.36	-	-
	11d	The primary “take-away” lessons of this case report	33/33	100.00	-	-	-	-
Patient perspective	12	When appropriate the patient should share their perspective on the treatments they received	3/33	9.09	1/33	3.03	29/33	87.88*
Informed consent	13	Did the patient give informed consent? Please provide if requested	6/33	18.18	4/33	12.12	23/33	69.70*

1) ‘n’ means the number of which case reports match each assessment criteria of items: Sufficient, Not-sufficient, and Not-reporting, respectively.

2) ‘N’ means that the number of case reports having applicable item.

3) ‘*’ indicates that the percentage of not-, or not-sufficiently reporting item more than 50%.

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